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HOW IT WORKS

The economics and the experience of self-funding

How the Roundstone Captive Solution Works

The Roundstone Captive enables companies to self-insure safely. With our three-tiered model, you pay for healthcare costs up to a specific deductible, you share some costs above that deductible across a pool of hundreds of other employers in the Captive, and finally, you shift costs to a stop-loss carrier to cover catastrophic claims. The Captive, with its thousands of lives, acts as an additional protective layer that absorbs risk, reduces stop-loss fixed costs, and gives smaller companies the advantages of self-insuring like the Fortune 500s.

Your new self-funded plan will have 3 cost “layers”:

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CARRIER

Shift Healthcare Costs to a Stop-Loss Carrier

The employer purchases stop-loss reinsurance to cover large claims above $500,000.

CAPTIVE

Share Healthcare Costs with Other Employers
The employer shares a portion of total costs with a pool of hundreds of other employers in the Roundstone Captive.

EMPLOYER

Pay Healthcare Costs
The employer pays for employees’ and families’ care up to a custom deductible.

CARRIER

Shift Healthcare Costs to a Stop-Loss Carrier

The employer purchases stop-loss reinsurance to cover large claims above $500,000.

CAPTIVE

Share Healthcare Costs with Other Employers
The employer shares a portion of total costs with a pool of hundreds of other employers in the Roundstone Captive.

EMPLOYER

Pay Healthcare Costs
The employer pays for employees’ and families’ care up to a custom deductible.

Does this mean I have to use the same plan as the hundreds of other companies?

Absolutely not. Your plan is your own. It’s customized to the individual care needs of your employees. Roundstone’s solution gives you complete flexibility in plan design. You end up with great healthcare at a lower cost. And the best part is that you can evolve and optimize your plan as you learn more from your claims data for a highly effective long-term healthcare strategy.

Who's Who in a Self-Funded Health Plan?

Self-funding is an employer-centric solution. Everyone involved is aligned around the best interests of the employer: Benefits Advisor, Roundstone, Third Party Administrator (TPA), and Pharmacy Benefit Manager (PBM). They work together as one integrated team to manage and administer the health plan, process claims, and make sure everything is running optimally. It’s a seamless experience.
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Roundstone is different from other stop-loss carriers in that we manage the group captive and we provide employer-centric customer service throughout. It’s important to note that Roundstone provides personalized service and attention for advisors, too. We help to ensure success and are always aligned with the employer’s best interests.
Learn More About Who’s Who In A Self-funded Health Plan

How You Save Money with a Self-Funded Plan in the Captive

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First, you only pay for the healthcare you use — what you deserve to pay and nothing more. Any savings from the claims account stays with you.

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Second, we return any unused premium from the Captive annually to employers on a pro rata basis — $10M in 2023 alone, for example. Annual distributions are based on Captive performance — not one individual company. You can still receive a distribution even if you had a bad claims year.

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Third, we prefer transparent and pass-through Pharmacy Benefits Managers who send 100% of pharmacy rebates and savings back to you.

Unlike traditional fully-insured plans where the carrier pockets any unused spend as profit, you get it back in full. You only pay for the healthcare you use.

Our Guarantee to You

Roundstone is so confident that your company will save money that we offer the Roundstone Guarantee: We promise you will save money in the first five years — or we’ll make up the difference. 

Watch and see how Roundstone helps employers provide better healthcare at a lower cost.

You gain complete transparency

  • Data and analytics to make informed decisions to further lower cost and improve care quality.
  • Our Cost Savings Investigators work one on one with you to identify savings opportunities and provide recommendations to further drive down cost. Clinicians, advisors, data analysts, claims managers - all work together to proactively optimize plan utilization and spend.
  • We provide the most effective and fully vetted cost containment solutions on the market.
See Our Integrated Cost Containment Solution

Transitioning to Self-Funded Insurance is Easy and Seamless

We provide hassle free onboarding, claims management, customer service, and plan design strategy.

There’s no disruption. Your employees will still have:

  • Same ID Cards
  • Same Doctors
  • Same Pharmacy
  • Same Hospitals

They’ll get a great experience and great benefits at a lower cost. You get affordable healthcare without having to sacrifice quality.

How the Roundstone
Captive Works

Want a deeper dive into how self-funding health benefits in the Roundstone Captive works? Watch this video to learn the fundamentals.

What’s the First Step?

Contact us for a collaborative, no obligation health plan assessment. We’ll craft a custom proposal to save you money on healthcare.
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STEP 1:

Schedule an Intro

– Learn about Self-Funding –

– Engage your Advisor –

– Request a Proposal –

Make a Choice Icon

STEP 2: 

Make a Choice

– Review Your Options –

– Customize Your Plan –

Start Saving Icon

STEP 3:

Start Saving

– Enroll –

– Implement –

Request Your Quote Today